BiasMedium
Length of Stay False Diagnosis Cut Off Insurer's Payment for Treatment of Elderly Woman
- Occurred
- Jun 3, 2019
- Published
- Mar 13, 2023
- Source
- AI Incident Database
Summary
An elderly Wisconsin woman was algorithmically determined to have a rapid recovery, an output which the insurer based on to cut off payment for her treatment despite medical notes showing her still experiencing debilitating pain.
Developers
- NaviHealth
Deployers
- Security Health Plan
- NaviHealth
Harmed parties
- Frances Walter
- Elderly patients
Classification
Category confidence: 85%
Severity confidence: 80%
Rationale: Algorithmic decision denied medical payment based on flawed recovery assessment, causing harm to patient.
Classifier: Qwen/Qwen3.5-35B-A3B-FP8